Maternal serum polyol levels associated with gestational diabetes mellitus and large for gestational age infants: a population-based nested case-control study.
Polyols, natural nutritive sweeteners, are commonly found in the diet during pregnancy. This study investigates the association between maternal serum polyol levels and the risks of gestational diabetes mellitus (GDM) and large for gestational age (LGA) infants.
This nested case-control study matched 218 women (GDM vs non-GDM) by age and body mass index (BMI). After exclusions, the final analytic sample comprised 194 women for glucose metabolism outcomes and 177 for birth weight and LGA outcomes. Serum polyols (sorbitol, erythritol, xylitol, and maltitol) were quantified using gas chromatography coupled with time-of-flight mass spectrometry. LGA was defined as birth weight ≥90th percentile or ≥4000 g. Logistic regression was used to assess associations between polyols and GDM and LGA, with adjustment for confounders.
Among the participants, 23.7% had LGA infants, and maternal serum polyol levels were significantly higher in this group. After adjusting for confounders, a 1-SD increase in serum polyol levels was associated with increased odds of LGA (OR 1.71, 95% CI: 1.22-2.40) and GDM (OR 1.52, 95% CI: 1.09-2.14). Erythritol and sorbitol were significantly associated with the odds of LGA, while xylitol and maltitol showed no significant associations. Additionally, a 1-SD increase in serum polyol levels was linked to higher birth weight (β= 95 grams, 95% CI: 33-157 grams) and elevated homeostasis model assessment for insulin resistance (β= 0.32, 95% CI: 0.12-0.52).
Elevated maternal serum polyol levels were positively associated with the risks of GDM, LGA infants, and higher birth weight.
This nested case-control study matched 218 women (GDM vs non-GDM) by age and body mass index (BMI). After exclusions, the final analytic sample comprised 194 women for glucose metabolism outcomes and 177 for birth weight and LGA outcomes. Serum polyols (sorbitol, erythritol, xylitol, and maltitol) were quantified using gas chromatography coupled with time-of-flight mass spectrometry. LGA was defined as birth weight ≥90th percentile or ≥4000 g. Logistic regression was used to assess associations between polyols and GDM and LGA, with adjustment for confounders.
Among the participants, 23.7% had LGA infants, and maternal serum polyol levels were significantly higher in this group. After adjusting for confounders, a 1-SD increase in serum polyol levels was associated with increased odds of LGA (OR 1.71, 95% CI: 1.22-2.40) and GDM (OR 1.52, 95% CI: 1.09-2.14). Erythritol and sorbitol were significantly associated with the odds of LGA, while xylitol and maltitol showed no significant associations. Additionally, a 1-SD increase in serum polyol levels was linked to higher birth weight (β= 95 grams, 95% CI: 33-157 grams) and elevated homeostasis model assessment for insulin resistance (β= 0.32, 95% CI: 0.12-0.52).
Elevated maternal serum polyol levels were positively associated with the risks of GDM, LGA infants, and higher birth weight.